One way that doctors and researchers have improved colon preparation is the implementation of the split dose regimen. Instead of consuming a large volume of cleansing solution the night before your colonoscopy, you now can split the dose into two halves. One dose is taken the night before your colonoscopy, and the second dose is taken about four to five hours before the procedure (Source: NCBI).

The split-dose bowel preparation has many benefits, such as improved patient acceptability and better cleansing. The U.S Multi-Society Task force recommends the split-dose preparation specifically because it has proven to increase adenoma detection rates (ADR). Recent studies also show that split-dose preparation is associated with a higher detection rate for sessile serrated polyps during colonoscopy exams. A sessile serrated polyp is a premalignant, flat lesion that is mostly seen in the cecum and ascending colon. These polyps are thought to lead to colon cancer through a different pathway than most colorectal cancers.

A randomized study led by Nicholas Horton, MD, of the Cleveland Clinic, found that the detection rate for sessile serrated polyps was 9.9 percent with split-dose preparation compared to 2.4 percent with single-dose preparation. A total of 17 percent of the lesions were identified as sessile serrated polyps in the split-dose group compared with only 4.4 percent in the single-dose group.

Horton and his colleagues studied 341 patients whose mean age was 54. One group consumed 2 liters of bowel prep solution as a single preparation the night before their colonoscopy. Another group consumed half the solution on the night before and half on the morning of the colonoscopy. Both groups were instructed to only have clear liquids.

Overall, there was little difference between the two groups in the detection rates of polyps and adenomas or in the location, size or number of polyps identified. Polyp detection rates in the single-dose and split-dose groups were 55 percent and 59 percent, respectively, while adenoma detection rates were 32 percent and 37 percent. Any proximal polyps were identified in 67 percent of the single dose and 61 percent of the split-dose groups, respectively, while any distal polyps were detected in 66 percent and 70 percent.

The split-dose preparation certainly does perform as well as the single-dose preparation. One of Horton’s colleagues, John Vargo, M.D., MPH, who was not involved in the study, concurred with Horton’s findings. He said Horton’s group “found that the split dose benefited the patients in several important ways, such as allowing more flexibility in scheduling and most significantly, resulting in a higher detection rate of sessile serrated polyps. I think that their findings, along with previous research, will encourage many healthcare providers to reconsider making patients consume the bowel preparation in one large dose,” he said (Source: MedPageToday).

A colonoscopy may not be your first choice of how to spend your day, but have you ever considered how useful a colonoscopy can be in diagnosing digestive disorders and conditions? By emptying your bowel and allowing your doctor to view your entire colon with the help of a lit colonoscope and a viewing monitor, you can have a clear “picture” of your digestive health! Just look at these seven benefits of having a colonoscopy:

1. Colonoscopies help detect colon cancer. One in every 20 Americans will develop colon cancer, and colonoscopies are the most effective means of prevention, diagnosis and treatment. No other colon cancer screening is as thorough and comprehensive.
2. Polyps can be removed during a colonoscopy. Most colon cancer develops from polyps, fleshy tumors that begin as benign but have the potential to become cancerous if allowed to grow. During a colonoscopy, your doctor can remove suspicious polyps so that they can never become cancer.
3. Colonoscopies can diagnose colitis. Colitis is chronic inflammation of the colon. If your doctor finds inflammation in certain areas of your colon, you can begin receiving treatment immediately.
4. Diverticulosis and diverticulitis can be diagnosed during a colonoscopy. Pockets in the intestinal wall can become infected over time and cause pain and discomfort. Your doctor can assess the severity and extent of either condition and recommend a course of treatment.
5. Colonoscopies can detect bleeding lesions. Bleeding lesions can be present in many different areas of the colon. A colonoscopy examines the colon from the rectum all the way to the cecum, so your doctor will be able to see the lesions during the exam.
6. Colonoscopies are used for abnormal barium x-ray exams. If you have a barium x-ray exam and an area of suspicion is found, a colonoscopy will offer a better view of the affected area of the colon.
7. Colonoscopies are the best exam to help diagnose the cause of abdominal pain. Symptoms like anemia, weight loss, abdominal pain, or cramping could arise from many different causes. A colonoscopy can determine whether the symptoms you are experiencing are related to colon disease.

Everyone knows that the downside of a colonoscopy is the prep. No one likes the idea of a liquid diet or drinking laxatives mixed with Gatorade. Some people have no trouble stomaching the polyethylene glycol solution, but others complain of nausea, bloating, vomiting, and abdominal discomfort.

Now with the split-dose prep, patients can consume a lower volume of liquid in two intervals. One dose is taken the night before the colonoscopy, and the next dose is taken the day of the procedure. Many veteran colonoscopy recipients have some tried-and-true methods that make colonoscopy prep more palatable. Some of these tricks include:

• Making the prep solution as cold as possible
• Mixing the prep with orange Crystal Lite
• Drinking the solution through a straw
• Trying to drink the solution as quickly as possible

A recent study in Seoul, South Korea, led by Jisun Lee, R.N., and colleagues, found that chewing gum could help the undesirable side effects of colonoscopy prep. The team asked 66 participants to chew one stick of sugarless gum during the pause interval of drinking a polyethylene glycol solution while 65 patients (control group) did not chew gum.

The gum-chewing group had significantly fewer complaints of nausea, abdominal discomfort, vomiting, and bloating. They also consumed their solution at a faster rate than the control group.

The authors concluded after the study, “Gum chewing was demonstrated by this study to be a potentially effective nursing intervention that is easy for patients to perform with simple instructions and is low cost with no side effects.”

If you are getting ready to have your colonoscopy, it might be time to go buy your favorite flavor of Juicy Fruit, Hubba Bubba, Wrigley’s, or Big League Chew. Smack it, pop it, blow bubbles, and indulge. You might just be making your colonoscopy prep a little easier and a lot more fun (Source: Medical Xpress).

When it comes time to get a colonoscopy, it’ll be a no-brainer for me. I’m going to schedule one. I’m not 40 yet, but I’ve already had two mammograms. When I found out that my health insurance company paid for a mammogram each year but did not have any age requirement, I flashed my insurance card and signed the dotted line. I have four kids, and they depend on me to stay healthy so I can take care of them!

But just like anyone else, I get nervous when I have to have a new test or screening. I want to know how uncomfortable a procedure will be and how I should prepare for it. My favorite thing to do is to ask friends to share about their experience so I can benefit from their advice. Getting my first colonoscopy will be no different. Spare no details! Just tell me everything.

The Colon Cancer Alliance is a fantastic resource for all colon-related topics. One of my favorite pages is their Colonoscopy Prep Tips. Here are a few of the funny, practical tips that real people have shared to help people like you and me to have a positive colonoscopy experience and ease our anxiety.

One complaint that people have is how hungry they are on the prep day. Clear liquids are not very filling, so Glenda B. has this tip:

• For supper, my husband heats up a can of chicken noodle soup and strains out the chicken and noodles. Tastes better than broth.

It might be a good idea for the rest of the family to go out to dinner on the night before your procedure. Nancy M. says:

• Don’t let anybody cook anything. You can’t eat, and when you smell food, it makes you so hungry. 

Other people complain about the taste of the prep solution. Lynn B advises:

• Mixing the Golytely with Orange Crystal light by the glass makes it so much more tolerable.

Prep solutions are meant to make you “go,” and it can take its toll on your derriere. Ashley H. says,

• WET TOILET PAPER/BABY WIPES. Towards the end, your bum will be pretty sore. You will be happy to have some on hand. 

More advice for sore bottoms from Shanna B:

• Diaper rash ointment!! You will get pretty sore. Use it right from the beginning and you will prevent the pain! 

Amy Jo E. has a great sense of humor and gives this suggestion:

• Oh, don’t forget to “write” a nice note on your tush to surprise your doc. Hilarious!

Don’t let jitters keep you from getting a colonoscopy. By talking to friends about their colonoscopies, you can glean many prep tips from their experiences so that you can be confident and informed for your first procedure. Remember, it’s just one day of your life, but the benefits far outweigh the inconvenience. You can do this, and so can I! I’m not saying that I am looking forward to my first colonoscopy, but when it’s time, I will be armed with plenty of tips and suggestions to put to good use!

There are over 29 million diabetics in the United States, and the number is steadily increasing. Every year, thousands of diabetics schedule colonoscopies. If you have diabetes, a colonoscopy prep can be challenging because it means missing meals or changing your eating schedule. Therefore, it is especially important to monitor your blood sugar throughout the prep period.

Here are some tips for a successful prep that is compatible with a diabetic menu:

On the day before your colonoscopy, you should aim for 45 grams of carbohydrates at meals and 15 to 30 grams of carbohydrates for snacks. You have several options for clear liquids that have no carbohydrates. Some of these choices include fat-free broth or bullion, clear diet soda, coffee, tea (unsweetened or diet), seltzer and flavored water.

You can have clear liquids that do contain carbohydrates but you need to monitor the amount. Use this as a guide:

• 4 oz. apple juice— 15 grams
• 4 oz. white grape juice— 15 grams
• 8 oz. Gatorade— 14 grams
• ½ cup Jell-O (regular, sweetened)—15 grams
• Orange popsicle (read the label)—15 grams
• Italian ice (read the label)— 30 grams
• 1 teaspoon sugar (for coffee or tea)— 4 grams

Here is a sample menu for your prep day

Breakfast	Lunch	Dinner
Apple or white grape juice— 1 cup	Broth— ¾ cup	Broth— ¾ cup
Regular sweetened gelatin— 1 cup	Italian ice— ½ cup	Strained fruit juice— 1 cup
Tea with lemon	Regular sweetened gelatin— ½ cup	Regular sweetened gelatin— ½ cup
	Tea with lemon	Tea with lemon

On the day of the colonoscopy

1. Bring your glucose meter, test strips and low blood glucose treatment with you on the day of your procedure.
2. Schedule the appointment for early in the day so that you can eat as soon as possible and take your medication.
3. Resume your normal medication schedule.

Don’t you just love free advice? Everyone has an opinion and wants to share it. Marriage advice. Legal advice. Parenting advice. There’s never a shortage of free, unsolicited advice and much of it is totally useless. Well, take heart. Here is some free advice that is worth its weight in gold. The Colon Cancer Alliance compiled a list of free advice about colonoscopy prep and you are the lucky recipient!

Maybe you are getting ready for your very first colonoscopy and you feel nervous or unprepared. Maybe your first colonoscopy prep was a little rough and you would like to have a few more tricks up your sleeve this time around. Or maybe it’s not even time for your baseline colonoscopy, but you just want to read as much as you can so you are ready when your special day arrives! Whatever your reason might be, just enjoy reaping the benefits of someone else’s colonoscopy prep experiences. Here is a little teaser of the complete list from the Colon Cancer Alliance:

 

The Day Before the Prep

1. Eat a large breakfast, small lunch and tiny dinner. The prep day will be so much easier.
2. Stop eating meat at least five days before the procedure.
3. Go to liquids-only diet at least three days before the prep.
4. Write a nice note on your tush to surprise your doc.

On Drinking the Prep

1. Drink it cold. Chase it with cold water.
2. Don’t mix [the prep] with your favorite drink flavor because you may always associate that flavor with the prep.
3. Use a straw to drink any prep…It goes down faster and you don’t really taste it.
4. Gummy bears dissolve at body temperature to a clear liquid so they are okay to take with the prep and give you something to eat.
5. Stick the prepared prep in the freezer for an hour or two before you drink it.

During the Prep

1. WET TOILET PAPER/BABY WIPES. Towards the end, your bum will be pretty sore.
2. Don’t let anybody cook anything. You can’t eat, and when you smell food, it makes you so hungry.
3. Just drink the prep while on the toilet… you’ll be there for a while!
4. Softest toilet paper money can buy!
5. Laughter with a friend (whether via phone or in person) during the whole prep! Makes it so much easier!
6. Ice, pinch my nose and lots of Preparation H.

 

Make sure to visit the Colon Cancer Alliance’s 27 Insider Tips and Tricks for Colonoscopy Prep to read more helpful and humorous insight on how to get ready for your colonoscopy. The best part is that all advice is FREE!

The holidays are coming. Finally! It’s time to think about turkey, football, gift giving, decorating and a colonoscopy. Wait, one of these items don’t seem to fit the theme… or does it? A colonoscopy may not be what you might think of during this season, but the holidays are a perfect time for a colon screening. You may think that scheduling a colon screening may interfere with your family plans or your holiday schedule, but it may not be as inconvenient as you may think. Here are a few reasons that the holidays are actually the best time to schedule your colon screening:

1. Most people have a day or two before and/or after a holiday. Some people will take a few days off around a holiday. You will have to miss at least one day of work for your colonoscopy. Why not schedule your procedure when you will not have to go to work the following day? Sometimes a day before or after a holiday might actually work in your favor.
2. Your husband, wife, family member or friend may be off work as well. You will need a caregiver to drive you home from your colonoscopy because the sedation medication will still be in your system. Scheduling your colonoscopy around the holidays may prevent you and your caregiver from taking extra days off work.
3. On your bowel prep day, there will be plenty of holiday movies to keep you entertained while you spend quality time in your pajamas near the bathroom.
4. Holiday foods will taste even better after you have had your procedure!
5. You will have lots of support from your friends and family who may be visiting during the holidays.
6. Since it is the end of the year, you may have met your health care deductible. You may have very little financial responsibility for your colonoscopy, or it may be fully covered.

End the year with a commitment to good health. Scheduling a colonoscopy around the holidays will be one of the best decisions you can make. Do not delay in making your appointment, as doctors also like to take time off as well! Call your insurance provider to ask about your colonoscopy screening benefits and inquire about what your out-of-pocket cost will be. Then, you will be ready to schedule your procedure. Happy Holidays and Happy Colonoscopy!